卒中相关性肺炎的发病机制及预测因素的研究进展

Research Progress of Pathogenesis and Predictive Factor of Stroke-Associated Pneumonia

卒中相关性肺炎(SAP)是急性脑卒中患者的主要并发症之一,发生和发展相对于普通肺炎有其独特之处。SAP的发病与卒中后的免疫抑制状态、细菌定植、误吸及神经源性肺水肿有关,其危险因素包括年龄、体位、误吸、意识障碍、吞咽障碍、心房颤动、糖尿病史、气管插管和机械通气、鼻饲饮食、镇静剂使用、应激性溃疡预防用药等,国内外学者针对这些危险因素制订了SAP预测量表以预测SAP的发生。

Stroke-associated pneumonia( SAP) is one of the major complications of acute stroke,and its occurrence and development have its own way compared with the ordinary pneumonia. The pathogenesis of SAP is related to immunosuppressive state after stroke,bacteria colonization,aspiration and neurogenic pulmonary edema,and its risk factors include age,position,aspiration,disorder of consciousness,swallowing disorder,oropharyngeal bacteria colonization,diabetes,endotracheal intubation and mechanical ventilation,enteral nutrition,sedatives,stress ulcer prophylaxis,and so on. Scholars at home and abroad have made SAP predictive scale according to these risk factors.